İlaç Anafilaksisi ve Perioperatif Anafilaksi
Elif SOYAK AYTEKİNa, Özge UYSAL SOYERa
aHacettepe Üniversitesi Tıp Fakültesi, Çocuk İmmünolojisi ve Alerji Hastalıkları BD, Ankara, TÜRKİYE
Soyak Aytekin E, Soyer Uysal Ö. İlaç anafilaksisi ve perioperatif anafilaksi. Akın C, Şekerel BE. editörler. Anafilaksi. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.34-44.
ÖZET
İlaç aşırı duyarlılık reaksiyonları, öngörülemeyen immünolojik reaksiyonlardır. İlaçlar erişkinlerde ve yatan hastalarda en sık, çocuklarda besinlerden sonra gelen en sık anafilaksi nedenidir ve tüm anafilaksilerin %31-42’sinin nedenidir. İlaç anafilaksileri önemli bir halk sağlığı sorunudur. Hastane yatışı, tedavi değişikliği ve yüksek sağlık maliyetine neden olmanın yanı sıra anafilaksiye bağlı ölümlerin en sık nedenidir. Antibiyotikler özellikle beta laktamlar, nonsteroid antiinflamatuar ilaçlar, iyonize kontrast madde ve dekstranlar ilaç anafilaksilerinin en sık nedenleridir. Tanı için ayrıntılı bir klinik öykü, in vivo ve in vitro testler gerekir. Perioperatif anafilaksi nadir görülür, tanı konulması zordur ve mortalitesi yüksektir. Sorumlu maddenin tespiti tekrarlayan maruziyetleri önlemek için oldukça önemlidir. Maruz kalınan tüm maddelerin tespiti, ayırıcı tanının yapılması ve reaksiyona neden olan maddenin doğrulanması için sistematik bir yaklaşım gereklidir.
Anahtar Kelimeler: İlaç anafilaksisi; perioperatif anafilaksi; ilaca bağlı erken aşırı duyarlılık reaksiyonu
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